摘要
目的 用血栓弹力图（TEG）血小板图分析急性创伤后血小板抑制功能的改变。方法 用TEG检测51例急诊创伤患者及48例健康人全血血小板二磷酸腺苷（ADP）抑制率及花生四烯酸（AA）抑制率,并用logistic回归分析创伤患者的高危风险因素。结果 创伤患者平均二磷酸腺苷（ADP）抑制率（%）为85.9（38.4,97.6）、平均花生四烯酸（AA）抑制率（%）为44.7（26.4,59.1）,健康人平均ADP抑制率（%）为4.4（0,18.1）、平均AA抑制率（%）为0.7（0,3.03）,创伤组与健康人对照组血小板抑制率差异有统计学意义（P〈0.01）。以ADP抑制率是否大于75%为cut off值,患者碱缺失（BD）〉6 m Eq/L（OR=3.21,95%CI：1.45~9.31）和6 h内至少输注血浆200 m L（OR=4.9,95%CI：0.89~28.8）为患者的高危风险因素;以ADP抑制率是否大于90%为cut off值,患者收缩压〈70 mm Hg（OR=12.4,95%CI：1.8~91.4）和患者6 h内至少输注红细胞悬液2 U（OR=8.7,95%CI：1.8~46.5）为患者的高危风险因素。结论 创伤患者血小板AA及ADP抑制率明显升高,血小板活化功能降低;血制品输注增加创伤患者风险。
Objective To analyze the changes of platelet inhibition function after acute trauma using the platelet mapping in throm- belastography（TEG）. Methods The blood platelet inhibition rates induced by arachidonic acid （AA） or adenosine diphosphate （ADP） in 51 patients with acute trauma and 48 healthy controls were determined by platelet mapping in TEG, and the risk factors of trauma patients were evaluated by logistic regression. Results The blood platelet inhibition rates [ M（ P25, P75 ） ] induced by ADP and AA in trauma patients[ 85.9% （38.4% , 97.6% ） and 44.7% （26.4% , 59.1% ） ] were significantly higher than those in healthy controls [ 4.4% （0, 18.1% ） and 0.7 % （0, 3.03 % ） ] （P 〈 0.01 ）. When 75 % was set as the cut off value of blood platelet inhibition rate induced by ADP, base defict（BD） 〉 6 mEq（ OR = 3.21,95% CI ： 1.45-9.31 ） and at least 200 mL of plasma transfusion during 6 hours post injury（ OR = 4.9, 95% CI ： 0.89-28.8 ） were risk factors. When 90% was set as the cut off value of blood platelet inhibi- tion rate induced by ADP, systolic blood pressure 〈 70 mmHg（ OR = 12.4, 95% CI： 1.8-91.4） and at least 2 units of red cell sus- pension transfusion during 6 hours post injury（ OR = 8.7, 95% CI ： 1.8-46.5 ） were risk factors. Conclusion The increased blood platelet inhibition rates induced by ADP and AA and decreased platelet activation function may be found in trauma patients, and blood products transfusion increase the risk of trauma patients.
出处
《临床检验杂志》
CAS
CSCD
2016年第10期742-744,共3页
Chinese Journal of Clinical Laboratory Science
基金
宁夏自然科学基金(NZ15192)
